Alphabet Soup

 RB “Doc” Hecker

 FAA HIMS/IMS Senior AME 20969

 SRA # 5171

 StearmanPartners

1942 Boeing-Wichita Division A75-N1 Stearman “51” powered by a Continental W670-6N of 220 HP swinging a Sensenich W98AA-66 propeller. This aircraft was completely restored in 2011.  It left the factory on 04/24/1942 as USAAC 41-25606 and CN 75-3113.  Owned by RB “Doc” Hecker (R) and his Stearman student partner Dr. Paul Celio (L).  Hangared at Bulverde, TX (1T8).  Photo by Frank Minard 10/2014.

 

Many years ago I was speaking with a certification specialist from the FAA regarding a pilot with multiple medical problems who had consulted outside agencies when I heard some mildly negative comments about the “alphabet” organizations… You can imagine who those groups are with short acronyms that represent their real names. All of us in the aviation community are used to these “alphabets”. If you are reading this article in the SRA newsletter you are a member of one (SRA). Come to think of it, the FAA is the prototypical alphabet agency! Just thinking about the irony of this makes me “LOL”.

Some of my pilot friends and aviation colleagues have noted that there are some new letters associated with my Aviation Medical Examiner practice – namely, that I now identity myself as a HIMS/IMS Senior AME. Those who ask me what that stands for are the fortunate ones…the others who KNOW what it stands for typically have begun a very long-term and expensive relationship with me. HIMS stands for Human Interventional Motivational Study…a very nice way of saying that if you abuse alcohol or drugs as a professional pilot and wish to remain medically certified, we have a program just for you. As an added benefit, if a pilot has been, or is being, treated for depression with a single drug (out of four approved), this program is very beneficial for that purpose. The FAA has decided that a pilot treated for depression and medically monitored by the HIMS program is safer than an untreated pilot.

I am seeing from the general aviation publications that the idea of a private pilot flying without a third class medical certificate (AKA driver license certification) has lost some momentum since its inception by the alphabet organizations - mainly due to US Government administrative processes. In fact, I attended a FAA Aeromedical Seminar this month where a brief mention of this issue was made by the FAA aeromedical representatives who stated that they did not know where this finally going to end up. I imagine we will have to wait for the FAA review process to complete, or for the legislative process to begin.

So … what to do? Let’s look at a case.

A 32 year old pilot presents with a history of incarceration for a felony conviction for “carjacking” at age 23. He was released from prison after serving 10 months of a 10 year sentence and remains on probation with the injunction to not leave his State of residence. He states that he reason he was stealing cars were his attempts to raise money to purchase an airplane to further his flying career. During the examination you find that he is sightless in his left eye and he tells you that his eye was injured during an industrial accident at age 28. He states he has been flying “professionally” since his eye injury healed. Finally, while reviewing your history and physical findings, the pilot relates to you that he has had multiple bouts of depression centered around his lack of funding to further his aviation career that have kept him from flying for short periods of time. In an expansive mood, the pilot states that he really needs this certificate as he wants to fly around the world solo in his single engine aircraft to set a world record for solo flight.

Aeromedical Case Summation: This is a 32 year old occasionally depressed convicted felon who has monocular vision and wishes to break his parole by flying solo around the world in a single engine aircraft. He has a valid driver’s license. Should I certify, deny or defer to the FAA at Oklahoma City? What would the good folks at OKC do with this case? Would they ask for more info? Would they risk the embarrassment of denying this airman a medical certificate knowing that the two major airports in the Oklahoma City area would have to be renamed after their action? I am sure the pilot, Wiley Hardeman Post, would like to know. His good friend Will Rogers would probably write an Op-Ed about the experience. This is obviously a difficult case.

All kidding aside, here is a partial list of the aeromedical issues I have seen this month:

  • Both 3rd and 2nd Class airmen with multiple DUI’s.
  • Both 3rd and 2nd Class airmen with multiple traffic/accident violations.
  • A 19 year old honors college student 3rd Class Student Pilot applicant with a history of major depression due to family stressors and who has been off medications for over a year. He recently received his Eagle Scout certificate.
  • A 1st Class airman on 12 month Special Issuance for a kidney disorder with an inadequate letter from his kidney doctor. My call to his doctor revealed he has not been seen for 2 years. He also has untreated hypertension.
  • A 2nd Class airman with a new heart rhythm disorder.
  • A 2nd Class obese airman on a Special Issuance for obstructive sleep apnea with newly diagnosed diabetes mellitus requiring oral multi-drug treatment.
  • A 3rd Class physician airman with recent cardiac stents.
  • Both 3rd and 2nd Class airmen with newly diagnosed non-obstructive cardiac disease.
  • A 3rd Class Student Pilot applicant with monocular vision due to lazy eye.
  • Both new and established pilots diagnosed with color vision deficiency.
  • A 3rd Class pilot on anti-depressive medication who refuses to provide to me his clinical notes regarding his depression.
  • An occasional pilot with a normal exam….

I am on the fence here. As a 63 year old pilot flying a 3,000 lb, 285 HP 4-6 place single engine aircraft, I would love to only have to hold a valid driver’s license to fly on a Private Certificate. How about a 3,000 lb, 220 HP 2-place antique single engine tail wheel aircraft? Of course, I would not be able to exercise my Commercial Certificate and would have to forgo receiving free 100 LL gasoline at air shows as payment for my participation. How about me instructing a rated pilot in a new aircraft while I am without a valid 3rd class medical certificate? On the other hand, as an Aeromedical Physician, I am somewhat concerned that many pilots forgo their needed medical evaluation in order to disclose or accept medical concerns. Is this wise? I am tending to the side that there needs to be a knowledgeable physician somewhere in the decision process to advise pilots and assist them to remain as healthy for as long as possible. I believe the AME is the proper physician to do this task of education and monitoring. Of course, as an AME who specializes in Special Issuance and difficult aeromedical cases, I am somewhat skewed in this direction.

Please remember this! The pilot AME is really your advocate. The FAA certifies 99.9% of the applications submitted once all of the required information and testing has been accomplished. Is saving the cost of real medical attention worth the risk of just getting your driver’s license? And, the “rest of the story” is that the alphabet organizations will sell you their brand of “education” to validate the driver’s license certification if it is approved. I am not sure what that cost will be. I am as interested (and vested) in this This email address is being protected from spambots. You need JavaScript enabled to view it. are always appreciated!

Keep the blue sky up and the nose on the centerline! Happy Holidays to all.

Doc Hecker 11/28/2014

RB “Doc” Hecker (SRA 5171) is a FAA Senior HIMS/IMS AME (20969) who retired from the US Army Medical Department in 1997 after 26 years of service. He holds certificates for CFI Single Engine Land & Sea, Commercial Pilot ASEL, ASES, AMEL, AMES, Glider, B-17 SIC and Instrument Airplane along with an A&P Mechanic Certificate. He has logged over 2,500 hours and prefers small, intimate airparks. He has restored a 1965 Cessna C210E (N4904U), a 1946 Taylorcraft BC12-D (NC43306),a 1946 Aeronca 7AC (NC2241E), refurbished a 1943 Aeronca O-58B / L-3B (NC47185), 1945 Stinson L-5CVW Sentinel (N178) and a 1947 Taylorcraft BC12-D (N43928). He is currently refurbishing a, and assisting the restoration of a 1947 Aeronca 7BCM / L-16 (N119TX). His other projects include maintaining a 1942 Boeing A75-N1. He has previously owned a Cessna C-172 (N61785), a Grumman AA-5B (N74447) and a Mooney M20C (N10AD). In his free time, Doc practices medicine in San Antonio, TX. He is a member of EAA Chapter 35 of San Antonio, TX, EAA Chapter 92 of Orange, CA, and is an EAA Technical Counselor and Flight Advisor. In addition, he is a Life Member of the Commemorative Air Force and affiliates with the Houston Wing (Houston, TX), Centex Wing (San Marcos, TX) and is an active member of the Gulf Coast Wing (Houston, TX) where he crews as a Co-Pilot, Flight Engineer and member of the maintenance team doing sheet metal and fabric repair work on that magnificent 1945 B17-G war bird “Texas Raiders” (N7227C).